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Doctors slam parts of malpractice plan

November 18, 2004|by TAMELA BAKER

tammyb@herald-mail.com

HAGERSTOWN - Gov. Robert Ehrlich renewed talks this week with General Assembly leaders, seeking solutions to the state's medical malpractice insurance crisis. Ehrlich already had met with House Speaker Michael Busch, and planned to meet with Senate President Thomas V. "Mike" Miller today to try to hammer out an agreement.

Some local physicians say they can't support some of the steps being discussed.

A point of contention is the funding source for a proposed stop-loss fund that would subsidize malpractice insurance premiums. Although the governor had not yet suggested a funding source, House leaders have proposed funding it through a 2 percent tax on HMOs.

"No physicians will look at that," said Hagerstown orthopedic surgeon Scott Worrell. "If you tax the HMO, it will be paying out less" for medical services in order to protect its profits, he said. "That's cutting off your nose to spite your face.

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"Patients are getting less and less service for what they're paying in premiums" already, he said.

Medical Mutual Liability Insurance Society of Maryland, which insures most of the state's doctors, is raising its rates by 33 percent for the new year - on top of a 28 percent increase last year. In an attempt to draw attention to the issue, some 60 local physicians postponed elective medical services scheduled this week so they could spend the time lobbying government officials - and the public - for relief.

The group, calling itself Save Our Doctors, Protect Our Patients, rallied in Annapolis on Wednesday, pressing for specific reforms, including:

· Adoption of tort reforms that would put more caps on malpractice awards - Maryland currently has a cap on noneconomic damages only.

· Tightening requirements for expert witnesses in malpractice cases.

· "Good Samaritan" protections for physicians performing emergency or crisis care.

· Malpractice insurance reforms.

· Creation of special courts for malpractice cases.

The group plans to hold a series of "Tuesdays in Annapolis" lobbying sessions until the issue is resolved, according to organizer Karl Riggle, a Hagerstown surgeon.

"The problem is well-understood and the solutions are apparent," said Brian Holmes, a Hagerstown neurosurgeon.

At Washington County Hospital, where about 75 percent of elective surgeries were postponed this week, administrators developed a contingency plan for other employees affected by the surgeons' actions.

Washington County Health System President and CEO James Hamill said nurses and other staff have been given other assignments. "We decided to try and not let it affect our staff's hours," he said. "We're catching up on other things."

"We have been able to accommodate the vast majority of staff, at all levels, by either working in other nursing areas, working on special projects, unit clinical competencies, orientation or cross-training," Mary Towe, executive for nursing at the hospital, said in a statement.

"There have been a few shifts where someone was either canceled or sent home early, but those instances have been rare. In the areas that have been affected by the surgeon slowdown we have made every effort to accommodate the nursing staff shift preference and the units they preferred to work on," she said.

"Much of this is similar to what we do on a daily basis as census fluctuates," Towe added. "During normal hospital operations, patient volume can fluctuate 25 percent to 50 percent in a 24-hour period, and we respond to that by flexing staff as needed."

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